A variety of surgical devices are known in the art to aid in performing surgical procedures. Typical surgical devices of this kind are fully rigid, including an elongate shaft rigidly affixed to a handle at a proximal end thereof. Such handles and any actuator thereon are typically configured with a pistol-type grip, as in the case of a surgical stapler, or with a scissor handle, as in the case of many other devices, such as some graspers, for example. The handles are typically arranged at the proximal end of the device, in-line with the longitudinal axis of the device or deviated therefrom by an acute angle. Examples of such devices are set forth, for example, in U.S. Pat. No. 7,258,262 to Mastri et al, U.S. Pat. No. 5,820,009 to Melling et al., U.S. Pat. No. 5,462,558 to Kolsea et al. and U.S. Pat. No. 5,728,121 to Bimbo et al., each of which documents is hereby incorporated by reference in its entirety.
Applicant recognizes, however, that such typical instruments pose difficulties when used in conjunction with other instruments in a small space, such as during laparoscopic procedures, and particularly during such procedures through a single or limited number of access ports. Under such conditions, typical devices in the art suffer from interference between handles and/or effector ends of other such devices.
Moreover, during laparoscopic surgical procedures, the movement of the surgical instrument tip is typically restricted to a region relatively proximal to an axis of a surgical access port, such as that of a surgical cannula. Typically, this disadvantage is mitigated through use of multiple access ports distributed across a patient's abdomen.
Increasingly, techniques are being developed for performing minimally invasive surgical procedures through a single access port. With the advent of such surgeries, it has become necessary to insert multiple instruments through a single access port. Accordingly, the relative motion of, and distance between instrument tips are restricted by the inner diameter of the access port. With traditional instruments, instrument effector ends can interfere with one another while also not being capable of reaching a wide range of areas, or of approaching such areas from different angles.
Additionally, as mentioned above, in such procedures with traditional laparoscopic hand instruments, it becomes difficult to manipulate the handles at the proximal end (user end) thereof, due to crowding due from mutual interference between multiple instrument handles in a relatively small area.
Certain surgical access devices or access “ports” have been developed which have particular advantages with single-incision surgeries, including those devices described in U.S. Pat. Nos. 7,182,752, 7,338,473, and 7,285,112, U.S. Patent Application Publication Number US 2007/0088275 and PCT Publication Number WO2008/077080, which documents are fully incorporated herein by reference. The surgical access devices described in these documents utilize a non-mechanical pressure sealing capability to prevent depressurization of the abdominal cavity during laparoscopic abdominal surgeries. The absence of reliance upon purely mechanical seals, as is common in traditional surgical access devices, allows for the simultaneous use of multiple instruments through a single access device inserted through a single incision, while maintaining a pressurized abdominal cavity (pneumoperitoneum). Traditional mechanically-sealed surgical access devices suffer from various drawbacks when multiple instruments are inserted, or even when a single instrument is manipulated off axis, usually resulting in loss of pneumoperitoneum and/or torn seals or other problems.
Accordingly, Applicant recognizes that there remains a need in the art for devices that are capable of reduced interference with other instruments, which facilitate simultaneous use of multiple instruments in a confined space.
Furthermore, one objective of the present invention, is to provide instruments that are particularly suited for use in single-incision surgeries, which allow for greater freedom of movement at the proximal end, reducing crowding and allowing the surgeon an ergonomically advantageous position. Another objective of the present invention is to provide a surgeon with a greater range of motion between instrument tips during laparoscopic surgery, particularly in single-port surgeries. Among other advantages, instruments in accordance with the invention will enhance a surgeon's dexterity, reduce fatigue and improve accuracy during laparoscopic surgical procedures, particularly during single-incision laparoscopic surgical procedures.